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Permit C ITY OF TIGARD PLUMBING PERMIT I, DEVELOPMENT SERVICES PERMIT #: PLM1999 -00296 , .� 1 3125 SW Hall Blvd., Tigard, OR 97223 (503) 6 171 DATE ISSUED: 9/20/99 SITE ADDRESS: 14980 SW 109TH AVE PARCEL: 2S110AD -90069 R � SUBDIVISION: CANTERBURY WOODS CONDO MINIUM �� BLOCK: LOT: 069 V RISDICTION: ZONING: TIC CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: 1 BACKFLOW PREVNTRS: OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: 1 CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Relocate water heater and washing machine. FEES Owner: Type By Date Amount Receipt ANDERSON, DANIEL W PRMT DEB 9/20/99 $50.00 99- 318466 308 SW FIRST AVE STE 110 SPOT DEB 9/20/99 $3.50 99- 318466 PORTLAND, OR 97204 Total $53.50 Phone 1: Contractor: ASAP PLUMBING 3913 G ST VANCOUVER, WA 98663 REQUIRED INSPECTIONS Phone 1: 360- 695 -1669 Top-out lnsp ec Final Inspection Reg #: LIC 99906 PLM 37 -450PB This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through 0/ R 952 -001 -1080. u may obta'riopies of these rules or direct questions to OUNC by calling (p3) 246 4C7. Is >,1 0 $ SLY/ , • Permittee Signature: A —/ / 0 Call (503) 639 175 by 7:00 P.M. for an inspection needed the ne business da CITY OF TIGARD Plumbing Permit Application Pla Check# 13125 SW HALL BLVD. Commercial and Residential Re . By , Ni, `I"IGARD, OR 97223 Date Rec'd ''- „Sr" (503) 639 -4171 Date to P.E. Print or Type Date to DST -- Incomplete or illegible applications will not be accepted Permit # /9Q -aC0q$ Related SWR # Called Name of Development/Project FIXTURES (individual) QTY PRICE AMT Job Sink 11.50 Address Street, 4e s �� Suite Lavatory 11.50 Tub or Tub /Shower Comb. 11.50 pot Bldg # 4 City/State Zip Shower Only 11.50 Name ^ r A'� Water Urinal (Specify) 11.50 41.0( 41.0( !!V1/„(,/I/( Dishwasher 11.50 Owner Mailing Address Suite Garbage Disposal 11.50 5,14) Washing Machine /Laundry Tray (Specify) ' 11.50 / li /State Phone 6 7 -1d O p Floor Drain /Floor Sink 2" 11.50 Name A 3" 11.50 0yyY1 4" / 11.50 Occupant Mailing A dress Suite Water Heater 0 conversion eke kind 11.50 Gas piping requires a separate mechanical permit. 1' i6 U City /State Zip Phone MFG Home New Water Service 28.00 /� MEG Home New San /Storm Sewer 28.00 Name/ti S ti !" / /(J ,4S Hose Bibs 11.50 Contractor Mailing d dre s % p Suite Rain Drains 11.50 Drinking Fountain 11.50 Prior to permit Ci y/ tate Zip • o e Other Fixtures (Specify) 15.00 issuance, a copy / s AI ` i► of all licenses are Oregon Con st, Cc Board Lic.# -.. Date , required if L - S '0a. expired in COT Plumbin Llc. # Exp. Date database 3 t 5 �� , "`�""�� j ~3 jeD® Name !` Sewer - 1st 100' 38.00 Architect Sewer - each additional 100' 32.00 or Mailing Address Suite Water Service - 1st 100' 38.00 Water Service - each additional 200' 32.00 Engineer City /State Zip Phone Storm & Rain Drain - 1st 100' 38.00 Describe work to be one: Storm & Rain Drain - each additional 100' 32.00 New 0 Rep ' O Replace with like kind: Yes l9' No 0 Commercial Back Flow Prevention Device 32.00 Residential Commercial 0 Residential Backflow Prevention Device* 19.00 Additippaljscriptio of work: Ct4 / // o Catch Basin 11.50 Insp. of Existing Plumbing 50.00 Are you capping, mov p ' or replacing any fixtures? per /hr Yes ��f No 0 Specially Requested Inspections 50.00 If yes, see back of form to indicate work performed by per /hr fixture. FAILURE TO ACCURATELY REPORT FIXTURE Rain Drain, single family dwellin 45.00 WORK COULD RESULT IN INCREASED SEWER FEES. Grease Traps 11.50 I hereby acknowledge that I have read this application, that the information QUANTITY TOTAL given is correct, that I am the owner sr authorized agent of the owner, and Isometric or riser diagram is required if Quantity Total is > 9 that plans submitted are in compliaj _with Oregon State Laws. *SUBTOTAL Signature o Owner /Agent 4 1 D �c// / Conta � �'ii_ , / ° I h ._ne CC JJ 7 %SURCH 5 c I - j�j . �I� � ,_ /� * *PLAN REVIEW 25% OF SUBTOTAL 1 BA 4 ' • SE $178.00 Required only if fixture qty. total is > 9 2 BATH HOUSE $250.00 TOTAL - 7 - ; - ( - )-. 3 BATH HOUSE $285.00 (This fee includes all plumbing fixtures in the dwelling and the first 100 feet of sanitary sewer storm sewer and water service) `Minimum permit fee is $50 + 7% surcharge, except Residential Backflow Prevention Device, which is $25 + 7% surcharge *`All New Commercial Buildings require plans with isometric or riser diagram and plan review. I: \dsts \forms\plumapp. do¢ 7/19/99 PLEASE COMPLETE: Fixture Type Quantity by Work Performed New Moved Replaced Removed /Capped Sink Lavatory Tub or Tub /Shower Combination Shower Only Water Closet Dishwasher Garbage Disposal Washing Machine Floor Drain /Floor Sink 2" 3" 4" Water Heater Laundry Room Tray Urinal Other Fixtures (Specify) COMMENTS REGARDING ABOVE: I: \dsts \forms\plumapp.doc 7/19/99 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line' 9-4 ;may : W BUP Date Requested 9 - � �f'� / 9 AM BLD Location t l q /Cv I (5 Suite MEC Contact Person Ph PLM 19 -dCZ99 Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall � Fire Sprinkler /P-1---00-. GL Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FL-UheialeLD Post & Beam Under Slab `Top Ou> Water Service Sanitary Sewer Rain Drains Af t) PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach/Sidewalk Other Date I J Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION h MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 / BUP Date Requested /O/ i /?c � AM PM BLD Location / 474-9K0 { � ,[� (0 - Suite MEC Contact Person NA A-- / - ✓,61A--• (mo Ph d - 33(x15 � PLM /9 9 -CO eRceo Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PA RT FAIL • LUMBIN j Post & Beam , Under Slab op ater Service Sanitary Sewer Rain Drains F � a� •ASS/ PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Inspector Ext - 9 InS other Date O� — p Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.